Provider Demographics
NPI:1912623679
Name:ORTIZ, SOMMER (FNP-C)
Entity type:Individual
Prefix:
First Name:SOMMER
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:ORANGE GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:78372-0301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S EUGENIA ST
Practice Address - Street 2:
Practice Address - City:ORANGE GROVE
Practice Address - State:TX
Practice Address - Zip Code:78372-2309
Practice Address - Country:US
Practice Address - Phone:361-382-2024
Practice Address - Fax:855-606-6314
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily